If there’s one thing that remains constant in the world of HIV, it’s that everything changes. The contents of this issue highlight this axiom beautifully.

Almost three years after the disappointment - and important learning curve - of the SMART study, the concept of structured treatment interruptions refuses to die. Why? Primarily because people living with HIV are not drug-taking robots but, rather, complex human beings. Many of us find it difficult - for a wide variety of reasons - to remain on a daily treatment for life.

Although it’s too early to say whether the two treatment-interruption protocols examined in this issue will ever be officially recommended, they counterpoint another study reported in this issue, that suggests starting treatment at a CD4 cell count of 500 results in a 70% reduction in illness or death compared to starting at 350 (as recommended by the most recent guidelines).

With one camp pushing for increasingly earlier treatment and another trying to make life with HIV a little easier (and more affordable), it’s not yet obvious from a patient’s point of view which is actually better (and safer).

If those of us who are old and experienced enough to be able to grasp the complexities of treatment adherence are confused, imagine how a young adult - who may have only recently learned they had been infected - feels. Their experiences, explored in the main article this month, remind us of the challenges of living with HIV at any age.

In this month's Upfront, we report on two new studies that may mean we re-examine whether structured treatment interruptions are as bad for our health as we had previously thought.

Ageing with HIV is not just a concern for the over-50s. There’s an increasing number of individuals born with the virus who are reaching young adulthood. Together with people first infected in their teenage years, the Growing pains experienced by this group of young adults are finally getting the recognition they deserve.

Last month, the world’s press reported that a 42-year-old American man living in Berlin had been ‘functionally cured’ of his HIV infection following a bone marrow transplant two years earlier. What exactly does A 'functional cure' mean for the rest of us?